1. Field of the Invention
The present invention relates to systems for storing and presenting surgeon-specific, surgical-procedure guidelines and preferences to surgical team members preparing for, and in particular, assisting surgeons during, surgical procedures.
2. Description of Related Art
It takes many people working together as a team to perform a surgical operation. The primary surgeon leads the team and is responsible for the safe and competent performance of the operation. Additional team members will depend upon the type of surgery, the precise procedures, and the primary surgeon's preferences. The team may include other doctors, advanced practice nurses, physician assistants, registered nurses, surgical technicians, manufacturer representatives, and other medical specialty personnel. The additional team members have specific supporting roles, are responsible for particular tasks, and strive to perform them as proficiently and accurately as possible.
Surgical facility personnel are normally responsible for obtaining, organizing, and preparing the necessary instruments, tools, equipment, and supplies required and preferred by individual surgeons to perform a surgical procedure. Although many surgical procedures require a certain basic set of instruments, most surgical procedures require certain specialized instruments, subject to surgeon preference regarding type, brand, style, and preparation for use. Preparation of an operating room for a surgical procedure involves appropriate positioning and set-up of furniture and equipment, which may be mandated by surgeon preference.
The surgical scrub, normally a nurse or technician, is the team member responsible for arranging and organizing the sterile instruments and supplies on one or more sterile tables and trays in preparation for a surgical procedure. Following proper patient positioning on the operating room table and appropriate surgical site preparation, the surgical scrub assists in draping the patient, according to surgeon preference, and creating a sterile field around the surgical site. Sterile cords and tubes required to connect sterile implements, such as electrosurgical and suction devices, to unsterile equipment are placed and secured to the sterile field according to surgeon preference and passed off the sterile field for connection.
Once the operation has begun, it is the job of the surgical scrub to pass the instruments, tools, and supplies to the surgeons at the appropriate time during the surgical procedure or when requested by the surgeons. The slightest mistake or delay by the surgical scrub in handling or passing an instrument to the surgeon can cause the surgeon to lose concentration and become frustrated with the surgical scrub. Thus, it is necessary that the surgical scrub not only be familiar with each step of the operation so that she will be ready with the next instrument to be used, but be familiar with the individual preferences of each surgeon and individual preferences of the first assistant if included as a team member. Individual preferences are often finely differentiated. For example, some surgeons prefer certain suture needles placed on a needleholder at the middle of the needle and at an angle of 90°, while other surgeons prefer the same suture needle used for the same purpose placed on the needleholder ⅔ from the tip at an angle of 60°. Current methods require surgical scrub personnel to memorize and recall the individual preferences of multiple surgeons and first assistants for multiple surgical procedures, skills that can only be achieved by surgical scrub personnel through extensive experience.
Over the years, various methods have been developed to assist surgical staff members in preparation for surgical procedures. One method is to manually prepare individual “preference cards” for each surgical procedure that a surgeon performs. These preference cards list the surgeon's name, the name of the surgical procedure, and the standard instrument sets or trays, equipment, and supplies that the surgeon prefers. Preference cards typically include personal preferences, such as the size and type of glove that the surgeon prefers, preferences for specific sutures and needles, and preferences for specific additional instruments not included in the standard sets or trays.
One such preference card 11 is illustrated in FIGS. 1A and 1B. As shown, preference card 11 is basically a form printed on an index-type card that has been filled out and updated manually by the facility staff. With this method, a separate preference card must be prepared and updated for each different surgeon and for each different surgical procedure that the surgeon performs. This is time consuming and susceptible to duplication errors. Because preference card 11 is maintained and updated manually by hand, preference card 11 is often messy, with scratch-outs and writing in the margins and on the back side. This makes preference card 11 difficult to read, which can lead to mistakes being made by the surgical facility staff when preparing for the surgical procedure.
Although preference cards are still in use today, many hospitals and surgical centers have implemented more advanced systems to be used by surgical facility staff in preparing for surgical procedures. For example, many hospitals and surgical centers now have computerized databases called “pick lists” that contain all of the instruments and supplies that are required for a particular surgical procedure. Pick lists are generally more detailed than preference cards and contain more specific information, such as part numbers for the instruments, and whether certain sterile packages should be opened prior to the surgical procedure or remain unopened but readily available.
One such pick list 13 is shown in FIGS. 2A and 2B. Pick list 13 provides details on which instruments and materials the surgeon will need and the state of readiness for each item. Thus, pick list 13 is useful for gathering the instruments, tools, and materials that will be used during the surgical procedure, but provides little assistance once the surgical procedure has begun. Pick list 13 may include a “comments” section, such as section 15, which might include some surgeon-specific preferences.
Another device used by hospitals and surgical centers in preparation for surgical procedures is a “resource map.” Resource maps are very similar to pick lists, with the exception that resource maps are more detailed and include fields to capture data on how many items on the list were actually used and how many were wasted. One such resource map 17 is shown in FIGS. 3A-3C. As is shown, resource map 17 is similar to pick list 13, with the exception that resource map 17 includes a column 19 to record which items were used and which were not used, or wasted. As with pick list 13, resource map 17 may include a section 21 that sets forth some surgeon-specific hints or preferences.
The significant drawback to preference cards, pick lists, and resource maps is that none of these devices are available to, or of practical use during, the actual surgical procedure by the surgical-scrub team member after donning a sterile surgical gown and gloves. In addition, none of these devices list the instruments, tools, and materials in the order of use during the surgical procedure. These preference cards, pick lists, and resource maps are arranged and organized by categories of supplies and instruments. For example, the different sutures are all listed together, the different instruments are listed together, the medicines are all listed together, etc. This makes sense, because preference cards, pick lists, and resource maps are designed to help surgical facility staff gather the supplies that will be needed for an operation, and these supplies are usually stored together in a supply room. These devices are not designed for use by the surgical scrub during an operation. The intra-operative surgeon-specific hints or preference information these devices contain must be studied and memorized by the surgical scrub prior to the surgical procedure.
Aside from preference cards, pick lists and resource maps, hospitals and surgical centers have developed other types of systems for use in conjunction with surgical services. These other developments include standardized surgical kits and complicated enterprise-wide systems designed to track inventory and costs associated with entire surgical departments.
All of the systems and devices described above are useful in preparing for a surgical procedure and some are designed to provide inventory management information. All of the systems and devices described above have the significant drawback of not providing the surgical scrub with intra-operative surgeon's preference guidance for a given surgical procedure. In addition, none of the systems or devices described above list the order in which particular instruments and tools will be used by a particular surgeon performing a particular surgical procedure. Furthermore, these devices and systems do not include any type of graphical representation of the instruments or how the instruments may be organized in the surgical theater. None of the systems or devices described above are designed to be used by the surgical scrub during the actual surgical procedure.
Therefore, while there have been significant developments in the area of surgical facility and procedure information systems, considerable shortcomings remain.